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I was at a sexology symposium recently, listening to a presentation on painful sex. And I found myself moved to tears.

There were stories of women who had endured pain for years.

There were stories of women who thought they were broken or abnormal for not enjoying sex.

What upset me is that sex is not meant to be painful. If there's pain, it's your body telling you there is something not working properly.

What struck me was that a lot of pain or unpleasant sex resulted from beliefs that sex is something that should be endured. That it is owed or something you need to do in order to get or to keep a relationship.

I will say it again: if you are experiencing pain, it's your body telling you that something ain't right and it's a good idea to check that out.

How common is experiencing painful sex?

I understand the distress experienced by those with the pain.

It is awful, lonely and often women aren't believed by lovers, friends and more importantly, medical practitioners.

Do you have a question related to sex or relationships you'd like us to look into? Email life@abc.net.au

A colleague of mine wrote her PhD on women experiencing painful sex. She found often they had seen upwards of 18 different practitioners and spent vast sums of money trying to find a solution.

If you are experiencing sexual pain and your doctor or health practitioner doesn't believe you, please search for someone who does — they're out there.

Australian data shows 20.3 per cent of women and 2.4 per cent of men have experienced physical pain during sex.

That's one in five women experiencing painful sex. I think that figure may actually be as high as 25-30 per cent based on my clinical experience.

An American study revealed about 30 per cent of women and 7 per cent of men reported pain during vaginal intercourse events, and about 72 per cent of women and 15 per cent of men reported pain during anal intercourse events.

Those figures are high.

Image Lack of adequate arousal can lead to pain, and disappointment, between the sheets.(Unsplash)

More than half of the painful sex presentations that I see are the body responding to:

Nowhere in their sex education or experiences has there been a focus on pleasure or understanding arousal systems for people with vulvas.

This lack of understanding can also apply to their sexual partners — who seem to be treating the vulva/vagina arousal systems as similar to a penis arousal systems. They are far from that!

A recent article on the female price of sexual pleasure attempted to explain this by pointing out the difference in definitions of 'bad' sex, in that bad sex for women involved pain or coercion. For men it involved missing out on specific sexual activities or having an orgasm.

When it came to good sex: again, for women it was free of pain or coercion, and for men it was related to a pleasurable experience and having their needs met.

These are completely different measurement systems.

I wonder what it would be like if women could focus on pleasure?

What is happening when sex hurts and what helps?

It may be tissues tearing (stinging pain), not enough lubrication, or muscles tensed (dull pain), or the body not warm and ready to 'receive'.

Some instruction on female anatomy and arousal can usually address these kinds of issues.

Take time to warm up and get your sexual engines purring — it's important and you will experience far more pleasure.

A focus on outercourse, not intercourse, will go a long way to addressing these issues.

If a person has been enduring unpleasant or painful sex for a long time, their body may have some issues, like muscles in spasm or nerve endings firing. These will need to be dealt with as well.

Image If you are experiencing painful sex, Tanya Koens says finding a professional or group of professionals can help.(Unsplash)

Vaginismus

Sometimes intercourse can be painful or impossible.

This may be due to a condition called vaginismus, which is an involuntary tightening of the pelvic floor muscles that can prevent anything (genitals, fingers, toys, doctor's examination instruments) entering the vagina.